Mental health policy and research in 2016 – a glass half full?
by Ian Bradshaw
At McPin we know that research and evidence are vital to improving the lives of people affected by mental health problems. But research does not take place in a vacuum. Decisions about what questions are seen as relevant, and what research (and how much) is funded are driven by people and how they respond to events in the outside world such as Brexit. Evidence does not change people’s lives unless it has an impact on policy and practice.
As we reach the end of the year I wanted to think about whether 2016 had been a glass half full or glass half empty year for mental health policy. I think it just tips into the half full camp, if only because it appears that the challenges we face in improving mental health in England are starting to get wider attention.
For mental health policy watchers the big event of the year came in February with the launch of NHS England’s Five Year Forward View for Mental Health, prepared by an independent taskforce chaired by Paul Farmer of Mind. Although the report highlighted the many shocking inequalities that people affected by mental health problems face, and the distance we still have to travel to achieve ‘parity of esteem’, the taskforce’s report at least set out an ambitious agenda for reform against which we can hold the NHS and the Government to account. It also highlighted the need for a more holistic view of mental health, taking into account issues such as employment and housing that are vital for wellbeing, and the links between mental and physical health.
Most important, from a McPin point of view, was the recommendation that the Department of Health (DH) produce a new 10 year strategy for mental health research. The Taskforce highlighted the lack of investment in research, and the gaps in the evidence base underpinning many existing treatments. Since the summer we have been working hard with DH on that strategy, successfully arguing that expertise from experience should be included around the table in the working groups they have created. The proof of the pudding will of course be in the eating, with the final strategy emerging in the spring next year.
Not surprisingly given the state of the Government finances, discussions have focussed on how we get the most out of the existing money, rather than arguing for more public money. However, we have been arguing that there is more Government could do to support charities like McPin and our colleagues in the Alliance of Mental Health Research Funders to raise money from the public and to provide strategic leadership themselves.
The main political shock of the year, in the UK at least, was the Brexit vote in June. As I wrote at the time, this raises many questions for mental health research, both financially if, as predicted, the economy slows, and from the disruption to the pan European funding, collaborations and workforce that is a strength of our current research economy in the UK.
Determined to be glass half full there was one chink of light from the fallout of Brexit: a new Prime Minister who was explicit that mental health would be one of her priorities – raising it repeatedly in her speeches before and after she entered No. 10.
Away from Westminster the strongest theme in mental health policy in 2016 has continued to be children and young people. The most shocking statistic I saw this year (in a crowded field) came from our friends at the Centre for Mental Health. They found that on average there is a 10 year gap between a child first experiencing mental health difficulties and receiving any help from the NHS. A decade. At least there now seems to be a growing consensus that this is unacceptable.
Overcoming the many challenges children and young people’s mental health faces is not just a question of more resources. We still know far too little about how to best help children and young people who develop mental health problems, let alone how to prevent them in the first place. We need sustained investment and commitment to research that addresses the issues that matter most to young people, their parents, and the professionals that support them. That is why are collaborating with the James Lind Alliance to launch a priority setting partnership next year. This will bring together the view of leading researchers, policy makers, parents and most importantly young people themselves to develop a list of the most important research priorities in children and young people’s mental health.
Finally 2016 has seen a growing movement towards local action on mental health. This time last year New York City launched their Thrive NYC programme of action the city would take locally to improve mental health and wellbeing. Following the election of Sadiq Khan in May, the Mayor of London’s office has been moving apace to draw up a London version that should be launched in spring 2017. We brought together a group of service users in May to inject some expertise from experience into their early thinking. We are now working with the working group looking at mental health and employment, making sure the evidence for what works and the voices of people with mental health problems are represented at the table.
So it has been a busy year, with a lot to build upon in 2017. We will continue to use our own research and patient involvement programmes to influence policymakers, and continue to make the case for high quality mental health research.